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Urinary Continence Product Order Form (Updated October 2014)Page 1 of 2Nursing / Care Home Patient Name D.O.B. CHI Address Person Requesting (Print) Signature Date Please Circle items / size required
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How to fill out urinary continence product order
How to fill out urinary continence product order
01
To fill out a urinary continence product order, follow these steps:
1. Start by gathering all necessary information such as the patient's name, contact details, and medical history.
02
Determine the type and quantity of urinary continence products needed by the patient. This may include items like adult diapers, bed pads, or catheters.
03
Contact the preferred supplier or medical equipment provider to place the order.
04
Provide the supplier with the required details, including the patient's information, product preferences, and any specific instructions.
05
Confirm the order details, including the delivery address and payment method.
06
Review the order for accuracy and make any necessary revisions.
07
Provide any additional supporting documentation, such as a prescription or insurance information, if required.
08
Place the order and ensure that all necessary payment and shipping information is provided.
09
Monitor the order status and track the delivery if applicable.
10
Upon receiving the order, verify the contents and address any concerns or issues with the supplier.
11
Store the urinary continence products in a suitable and accessible location until needed by the patient.
12
Make arrangements for any future orders or reorders as needed.
Who needs urinary continence product order?
01
Individuals who suffer from urinary incontinence or bladder control problems may need to place a urinary continence product order.
02
This may include patients with medical conditions such as urinary tract infections, prostate problems, pregnancy-related incontinence, neurological disorders, or other health issues.
03
Caregivers or family members responsible for the well-being of individuals with urinary incontinence may also need to place these orders on behalf of their loved ones.
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